Poison Sumac

What is Poison Sumac?

Poison sumac is a plant native to North America that causes a skin ailment by the same name. Poison sumac as a plant is known for being relatively innocuous until contact is made, after which a severe rash will begin to spread across all areas of contact. Poison oak as an ailment is known for being intensely itchy and irritating, and can all but incapacitate even the most resilient hikers.

Who gets Poison Sumac?

Everyone is vulnerable to poison sumac. There is no genetic disposition that leaves one vulnerable nor invulnerable to poison sumac, and individuals of all races and sexes are equally affected. Those that stay out of the wilderness are by and large quite safe. Poison sumac does not frequently spread to civilized areas and is but rarely seen growing in urban areas. Those that spend large amounts of time outdoors as a point of their hobby are thus most vulnerable to poison sumac. Those that are outdoors as a matter of employment are frequently better equipped to deal with and avoid poison sumac before it becomes a problem to begin with.

There is a single variable related to poison sumac that applies solely to the severity of individual cases of poison sumac. Between 15% and 30% of the population will not suffer any ill effects from poison sumac upon their first exposure. However, poison sumac provokes symptoms through immune response. Poison sumac secretes a chemical called urushiol oil from all its surfaces. Urushiol oil binds on contact with any skin cells that it should touch, which causes the immune system to perceive the cells themselves as invaders. For those 15-30% unaffected, the immune system does not learn to identify urushiol oil quickly enough to fight it effectively, and this lack of a reactionary defense mechanism means that no symptoms will actually present themselves in the skin. However, those that have been exposed to poison sumac (or urushiol oil) once will be sensitized to it and more vulnerable for all subsequent exposures. Thus, while no one is immune to poison sumac, there are many that are far more vulnerable to its symptoms than others, and these individuals would do very well to avoid further exposure.

What causes Poison Sumac?

Poison sumac is caused by exposure to the poison sumac plant. Poison sumac secretes a chemical called urushiol oil from all surfaces. Urushiol oil binds on contact with skin cells, and this binding lasts as long as the cells do. This urushiol oil exposure thus provokes an immune response. The immune system perceives the infected cells as pathogenic invaders and attempts to repel them accordingly. Every subsequent exposure refines the immune system’s ability to identify and battle poison sumac, which results in a more severe reaction and more severe symptoms.

Poison sumac is frequently mistaken for contagious. There are a number of factors that may make poison sumac seem communicable, but this is simply not true. Urushiol oil binds on contact with skin cells, and the immune system reacts to this. There is no bacteria or virus or parasite to incubate and possibly spread to other individuals, there is only the effect of the urushiol oil and the subsequent immune response.

For poison sumac to be contracted through a means other than exposure to a poison sumac plant, an object exposed to poison sumac would have to be shared. This would be a rare occurrence indeed, but it follows along with a general admonition against sharing unwashed garments and the like. This holds doubly true when one has spent time out of doors and has risked picking up various parasites and other undesirable things.

What does Poison Sumac cause?

Poison sumac (and all urushiol oil exposure) causes a host of unpleasant symptoms. These symptoms vary in severity from case to case, but do not vary in kind. There are no unexpected or unique reactions to speak of, merely a progression of symptoms that may or may not occur and may or may not be severe to some arbitrary degree. The first of these symptoms is pruritis.

Pruritis is, put simply, the medical term for ‘itching’. Pruritis is common to most forms of allergic reaction from some cause or other. In the case of poison sumac, pruritis occurs as a factor of the immune system’s assault on the cells it is meant to be protecting. This can aggravate local nerves and produce an intense, deep itching and burning.

The second reaction that generally occurs is redness, inflammation and warmth. This is the result of the immune system’s reaction attempting to raise the temperature of the affected location. This is a common response, and it is intended to destroy bacteria and virii. Much like what occurs in a fever, a simple difference of one or two degrees is frequently enough to bring about or accelerate the death of bacteria and viruses. This is what the immune system tries to do in the case of poison sumac. It perceives a pathogen and attempts to burn it out the same as it would with a virus or bacteria. However, in this case, the perceived pathogen is in actuality a skin cell with urushiol oil bound to it. This increase in temperature does nothing to eliminate the cell in place or the urushiol oil bound to it. Inflammation occurs as a result of the increased bloodflow. The bloodflow is the primary mechanism by which the body raises its temperature, and increases the amount of pus in the area. This is intended to help flush pathogens out faster (but again, the ‘pathogen’ here is more than a little different).

The third reaction that occurs in more severe cases of poison sumac and urushiol exposure is blistering. Blistering occurs when the immune system attempts to flood a location with pus, increasing the number of white cells in the area with the hopes of more being available to properly fight the invaders. Blistering, unfortunately, does little to help the binding of urushiol oil to skin cells. These blisters vary in size. They may be small pustules or be an inch or more in diameter. Over time, these blisters will rupture and drain on their own.

There are a few misconceptions about what poison sumac can cause. There are several rumors about it that are simply untrue. First and foremost, the rash caused by poison sumac does not spread. It cannot and does not spread to other areas of the skin. Urushiol binds on contact and cannot be transported afterward, nor spread. However, poison sumac’s rash frequently carries the illusion of a spread. The reason for this illusion is the density of exposure on the surface of the skin. Because the symptoms of urushiol oil exposure are a product of immune response, the sensitivity of the immune system is the primary factor in determining how severe the reaction will be. Areas of exposure that have been more densely saturated with urushiol oil are going to provoke a faster reaction as the immune system rapidly sensitizes and responds to the threat. Areas that are less saturated will respond more slowly, and symptoms will not present initially. This creates the illusion of a spreading rash. Scratching at the poison sumac rash is not, therefore, going to spread it farther. It will simply irritate the skin.

Poison sumac, additionally, is not contagious. There is no actual pathogen at hand that can be communicated. There is no viral cause and no bacterial agent that can incubate and jump from carrier to carrier. Individuals infected with poison sumac will frequently appear in clusters, however. This creates the illusion of a contagious nature, but once again, it is only an illusion. Because multiple individuals will have a tendency to develop symptoms at different times to varying severity, it may appear that one individual has spread it to the others that they have had close contact with. In truth, however, this is simply another matter of immune sensitivity. Those with stronger immune systems or immune systems sensitized to poison sumac will present symptoms more quickly, and those with less-sensitive or weaker immune systems will present symptoms sometime afterward.

The blisters caused by poison sumac can be quite large and unsightly. Because they represent the result of such a powerful immune reaction, they are filled with large quantities of pus, moreso than most skin reactions. Many individuals are unfamiliar with such large pustules, and as consequence, poison sumac (and other forms of urushiol exposure) are frequently mistaken for causing large amounts of contagious fluid that can spread poison sumac further. This is, however, untrue. Rupturing blisters do not carry any risk of poison sumac infection for exposed individuals.

A number of secondary effects may come into play with poison sumac and urushiol exposure depending upon how the exposure is treated and handled by the exposed individual. Individuals that scratch are likely to traumatize and damage the skin, and rupture blisters artificially. While this will not spread poison sumac, as it is frequently mistaken for doing, it will cause open sores. This can also occur if the blisters should rupture and drain naturally without being properly cared for and treated. These open sores open the body up to the possibility of secondary infections. A secondary infection with poison sumac simply means that some other agent has infected the system alongside poison sumac. This terminology can be confusing, as poison sumac represents a very different kind of infection than a bacteria or a virus can provide, but in any case, a secondary infection is a much more serious matter than poison sumac itself. A secondary infection’s symptoms are an entirely different matter than poison sumac’s, and are far more likely to require the intervention of a medical professional.

Poison sumac and urushiol oil carry an entirely different set of symptoms should they be inhaled. This can constitute a respiratory emergency even in individuals that do not suffer from a chronic or current respiratory condition. Treatment, symptoms and everything else are entirely different in this case, and only a trained medical professional is qualified to deal with such a situation.

How serious is Poison Sumac?

How serious a case of poison sumac is varies greatly depending on several factors. The first factor is the breadth of exposure. The more skin is exposed, the bigger a rash will be caused by the urushiol oil’s binding to the skin and the subsequent reaction of the immune system in trying to fight it off. The second factor is how dense the exposure itself is, and the third is how sensitive the immune system is to urushiol oil to begin with. All of these factors converge to varying degrees of severity in the resulting case of poison sumac.

Density of exposure simply refers to how much urushiol oil actually binds to the skin due to a given contact event with poison sumac. The denser the exposure, the more severe the immune reaction. Denser exposures will provoke different degrees of urushiol sensitivity in the immune system, as well. The density of urushiol exposure also variates the rapidity of symptom presentation. The denser the exposure, the greater the sensitization of the immune system and the faster the symptoms present themselves for that exposure event and all subsequent forms of urushiol exposure that may occur in the individual’s lifetime.

Sensitivity is simply an indicator of how powerfully the immune system responds. Ordinarily, the body’s immune system grows more and more adept at fighting off ailments that it has fought with in the past. This is why many ailments can only be contracted once: it isn’t that the body can’t come to carry those viruses again, it is that the body can fight them off before any symptoms can present themselves. In the case of poison sumac, however, there is no bacteria or virus to fight off. There is only the immune system’s perception of a threat. This perception of a threat still triggers an attempt to fight off the threat. Because the threat actually cannot be fought off by those means, this increased sensitivity never actually becomes an immunity to the ailment, but simply telegraphs an ever-increasing severity of symptoms with each subsequent exposure to poison sumac or other sources of urushiol oil. Thus, the more times an individual has been exposed to urushiol oil in the past, the more severe each subsequent case of poison sumac will be.

Exposure to poison sumac or urushiol in the lungs constitutes a medical emergency of an entirely different caliber and warrants immediate medical treatment by a professional.

What does Poison Sumac treatment look like?

Treatment for poison sumac varies somewhat depending upon the severity of an individual case, but there is a single factor that is invariable. Said factor is independent of each case of poison sumac: prevention. Prevention is always the first line of defense against poison sumac, poison ivy, poison oak and all other forms of contact dermatitis. If the ailment can be prevented, no further treatment is needed.

Most individuals subjected to poison sumac, poison ivy or poison oak are hobbyists, usually individuals out fo doors on vacation to camp or hike. The easiest means by which to develop a case of poison sumac is to brush a bare limb against poison sumac. Individuals wading through tall grasses or brush in short pants are the most likely candidates for poison sumac, especially if they are not watching where they are walking. Avoiding bare skin contact with all unidentified plants as a rule is generally a better idea, for reasons well in excess of avoiding poison sumac. Wearing long pants regardless of whether or not one has to actually wander through underbrush is also a good idea to avoid contracting poison sumac, although it is still not a perfect defensive measure.

An important element in prevention, as well, is identification. Most individuals are not aware of what poison sumac, poison ivy or poison oak actually look like, unless they have suffered from exposure already. Textual descriptions of poison sumac are common, but insufficient, and even photographic records of poison sumac are frequently insufficient to allow an inexperienced individual to consistently identify poison sumac out in the wild when it is relevant. Familiarization with poison sumac well in advance is necessary to safely identify poison sumac when relevant, but a far better option is to simply avoid handling any wild plants as much as possible.

Any other actions that risk skin exposure to poison sumac should also be avoided as much as possible. Sprawling in high grass, for instance, can be very relaxing, but it risks poison sumac exposure in locations other than the limbs. Poison sumac exposure on the trunk, neck and face can be far more difficult to deal with than poison sumac exposure on the limbs, feet and even hands. Facial cases of poison sumac can cause irritation to the eyes and nose and cause a host of difficulties that should be avoided under all circumstances.

Failing this extensive list of preventative measures, there are a number of treatments available for poison sumac. These vary in effectiveness, of course. The primary symptomatic treatment is calamine lotion, which smooths the skin, helps protect against various forms of damage and helps to reduce swelling and itching. However, most treatments for poison oak are nothing more than symptomatic. Because there is no true pathogen underlying cases of poison sumac, it is impossible to augment the immune system’s ability to fight off poison sumac. All that can be done is reducing the suffering caused by poison sumac until it is relatively imperceptible, and wait for it to run its course.

How do I know if I have Poison Sumac?

Poison sumac can easily be identified by exposure and subsequent symptoms. If no apparent exposure has occurred, the symptoms are still sufficient in and of themselves to identify poison sumac. All that this takes is the simultaneous possibility of exposure.